124 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES

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1 Cambodia Population i 14,562,008 Age structure 0-14 years (%) years (%) years and over (%) 3.4 Infant mortality rate (per 1,000 live births) both sexes ii 69 Life expectancy at birth (years) female 62.8 Life expectancy at birth (years) male 59.2 Maternal mortality ratio (per 100,000 live births) iii 540 Public social protection expenditure (% of total public expenditure) iv 32 Informal economy (%) v 72.8 GDP per capita Current USD vi 711 PPP (current international $) vii 1,951 Constant local currency viii 1,968,651 Unemployment rate (%) ix 1.68 Human development index (HDI rank x 137 HDI poverty indicators Human poverty index rank

2 124 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES

3 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 125 The National Social Protection Strategy for the Poor and Vulnerable: Process of Development Vathana Sann 6 Cambodia Summary Rationale behind the strategy: to accelerate progress towards the Cambodian Millennium Development Goals so as to reduce poverty and inequality, and to achieve socio-economic security for the population and bring coherence to policy formulation and implementation; The Strategy prioritizes the development of effective and sustainable social safety nets for the poor and vulnerable and establishes the framework for sustainable and comprehensive social protection for all Cambodians over the long run (including contributory and non-contributory schemes); The Council for Agricultural and Rural Development (CARD) is the governmental body mandated to coordinate and develop the social protection framework. Five objectives and key interventions (based on the vulnerability and gap analysis and consultation process in 2009 and 2010): 1. The poor and vulnerable receive support to meet their basic needs, including food, sanitation, water and shelter in times of emergency and crisis. 2. Poor and vulnerable children and mothers benefit from social safety nets to alleviate poverty and enhance the development of human capital by improving nutrition as well as maternal and child health, promoting education and eliminating child labour, especially its worst forms. 3. The working-age poor and vulnerable benefit from work opportunities to secure income, food and livelihoods while contributing to the creation of sustainable physical and social infrastructure assets. 4. The poor and vulnerable have effective access to affordable, quality health care and financial protection in case of sickness or illness. 5. Special vulnerable groups, including orphans, the elderly, single women with children, people living with disabilities, and people living with HIV and tuberculosis, receive income, in-kind and psycho-social support, and adequate social care. Instruments for social protection: Cash and in-kind transfers and fee exemptions; Public works programmes; Social welfare services. Information on the Author Vathana Sann, Deputy Secretary-General, Chief of Secretariat General of Social Protection Coordination Unit, Council for Agricultural and Rural Development.

4 126 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES I N T R O D U C T I O N Having emerged from three decades of instability, Cambodia has had an impressive record of sustained growth and poverty reduction. Yet Cambodians still face many serious forms of vulnerability, notably regarding weather-dependent agriculture, idiosyncratic shocks, and unand under-employment. The coverage of existing social protection programmes for the poor and vulnerable is very limited, and the presence of important sources of vulnerability (such as malnutrition, health shocks and poor quality of education) that remain inadequately addressed lead poor households into further destitution. To promote equitable growth in the near-to-medium term, an effective and affordable social protection system should be developed that supports the poor and vulnerable in coping with major sources of vulnerability while at the same time promoting human development. In the near future, priority should therefore be given to the development of effective and affordable social protection programmes for the poor and vulnerable that achieve these goals. An effective social protection system also promotes equitable growth and the government s ability to reform. To the extent that it encourages prudent risktaking and enhances opportunities for the poor, social protection can be beneficial for economic growth. Social protection can also help governments to embark on reforms that have long-term benefits in economic efficiency but high short-term social and political costs by providing effective compensation to those negatively affected by the reform. C O N T E X T In the last three decades, Cambodia has changed its political regime more frequently than any neighbouring countries. Cambodian society especially its social infrastructure also has experienced major changes and challenges. The Government managed to stabilize the famine situation prevailing in 1979 and made slow but steady gains in reconstructing schooling and basic health care. The population was organized into solidarity groups. This collectivization ensured equal access to the scarce male labour and draft animals available in , but as the economy recovered, it came to be seen as a hindrance to growth. Spontaneous de-collectivization, formalized through liberalization and land distribution in 1989, improved output and was welcomed by most although vulnerable groups lost important forms of social security (Frings, 1993). Great achievement in terms of infrastructure and human rehabilitation and development is tremendously significant. Cambodia had been embarking on a transition from war to peace, especially from one ruling party to multi-party politics, and from an isolated and planned economy to a free-market economy integrated into international trade. Since the Paris Peace Agreements in 1991, free and fair elections have been conducted. Since 1993, Cambodia has been transformed from a post-conflict society into a normal developing country.

5 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 127 P O V E R T Y P R O F I L E O F C A M B O D I A The last decade in Cambodia has been characterized by high rates of sustained economic growth, averaging 7 per cent growth in gross domestic product (GDP) per year between 1997 and Over the same period, per capita income doubled from US$285 to US$593 per year (GDP in 2008 was $711). Such growth has raised living standards and reduced poverty, which fell from an estimated 45 to 50 per cent of the population in 1994 to 35 per cent in 2004 and 30 per cent in Rising incomes and improved public services have contributed to improving human development indicators. Rapid growth and poverty reduction were accompanied by structural transformations: integration into the regional and global economy, a gradual shift of employment from agriculture to manufacturing, and migration from rural to urban areas. The last decade in Cambodia has been characterized by high rates of sustained economic growth, averaging 7 per cent growth in gross domestic product (GDP) per year between 1997 and Over the same period, per capita income doubled from US$285 to US$593 per year (GDP in 2008 was $711). Such growth has raised living standards and reduced poverty, which fell from an estimated 45 to 50 per cent in 1994 to 35 per cent in 2004 and 30 per cent in Rising incomes and improved public services have contributed to improving human development indicators. Rapid growth and poverty reduction were accompanied by structural transformations: integration into the regional and global economy, a gradual shift of employment from agriculture to manufacturing, and migration from rural to urban areas. Table 1 Cambodian population index and projections. Demographic Indicator * Midyear population (*1,000) 7,396 6,888 9,345 12,396 13,395 14,753 17,601 20,183 Growth rate (%) Total fertility rate (births/woman) Crude birth rate/1,000 population) Life expectancy at birth (years) Infant mortality rate/1,000 births Under-5 mortality rate/1,000 births Crude death rate/1,000 population * Data from 2008 general census. Source: National Institute of Statistics.

6 128 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Table 2 Profile of the poor. Quintile Stage Poorest Next Poorest Middle Next Richest Richest Owned agricultural land is secured by a title (%) Distance to nearest all-weather road (km) Distance to permanent market (km) Households with water pump (%) Plots with access to irrigation in dry season (%) Dependency burden (elderly and children per 100 economically active adults) Literacy, adults, age 15 and older (%) Education (average school grades completed by adults) Source: Cambodia Socio-Economic Survey (CSES) Poverty incidence largely remains a rural phenomenon. Despite impressive poverty reduction, one of three individuals continues to live below the poverty line. While poverty rates decreased in both urban and rural areas, inequality and the urban-rural divide increased between and Less than 1 per cent of the population in Phnom Penh was deemed to be poor in 2007, compared to more than 20 per cent in other urban areas and almost 35 per cent in rural areas, where approximately 80 per cent of the population lives. While Table 3 Poverty and inequality trends. % Population Poverty Headcount (%) Gini Coefficient 1993/ Phnom Penh Other urban Rural Cambodia Source: Knowles (2008) for the 2004 and 2007 data and World Bank Cambodia Poverty Assessment (2006) for 1993/1994 data. Owing to limited coverage of the 1993/1994 survey, poverty data for Cambodia in 1993/1994 have been extrapolated.

7 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 129 Table 4 Poverty levels of selected population groups. Group % Population % Poor Poverty Gap Elderly (65 years old or above) Employed Members of female-headed households Members of male-headed households Members of employed-headed households People with disabilities Ethnic minorities Infants (below 1 year old) Children (ages 0-14) Cambodia Source: Cambodia Socio-Economic Survey (CSES) inequality in Phnom Penh has decreased, it has increased in other urban and rural areas, leading to an overall increase in inequality from a Gini coefficient of 0.39 to 0.43 in only three years ( ) (table 3). A large proportion of the population also remains nearly poor and vulnerable to shocks that can push it into poverty. An increasing number of rural households have also become landless since land redistribution in the 1980s. A 2004 Oxfam study estimated that 20 per cent of rural households were affected by landlessness, with the number of those affected rising by 2 per cent per year. Another 25 per cent of households have less than 0.5 hectares, an insufficient amount of land to sustain them. The poor also lack or have few basic assets including draft animals or adequate housing that ensure a flow of income and can act as collateral to obtain credit. Lack of assets also means that the poor have few instruments to cope with consumption or income shocks. The non-diversification of household economies exacerbates the vulnerability of rural Cambodians. Most rural households rely heavily on subsistence agriculture for their livelihood, with rice cultivation accounting for 90 per cent of total cultivated area and 80 per cent of agricultural labour input. Cambodia s unique hydrological regime and very low levels of coverage by water-control infrastructure mean that agricultural production (and thus household food security) is heavily dependent on the weather and can fluctuate significantly from year to

8 130 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Table 5 Summary of the coverage of main risks. Age Main group Vulnerabilities Progress to Date Gaps and Challenges Early childhood (0-4 years) Stunted child development. Some maternal and child nutrition programmes are in place; Breastfeeding practices are improving. Supply of services remains limited and of poor quality; Coverage is not universal. Primary school age (5-14 years) Youth (15-24 years) High dropout rate; Poor quality of education; Child labour. Low productivity; Low human capital/skills; Underemployment. Some maternal and child nutrition programmes are in place; Breastfeeding practices are improving. Scholarships are improving attendance; Some programmes in place to improve quality of education and of vocational training. Supply of services remains limited and of poor quality; Coverage is not universal. Quality of education remains poor; Low attendance; Coverage is not universal; Almost nonexistent secondchance programmes to improve productivity of unskilled workers. Adults (25-64 years) Elderly and disabled Low productivity; Low human capital/skills; Underemployment. Low income; Underemployment. All groups Health shocks. Crises and natural disasters. Public works programmes are providing some assistance during lean season or crises. Pensions for civil servants; Some donor assistance to the disabled. Health equity funds are financing health care for the poor. Public works have shown to be an effective and rapidly expandable safety-net instrument during crises and natural disasters. Limited coverage; Funding and assistance remain volatile, defying their safety-net role. No pensions for the poor except for civil servants; Very limited assistance to the disabled. Quality of health care remains poor; Coverage and access are not universal. Limited coverage of existing public works programmes; Coverage is not universal and depends on funding year. In the first half of this decade, unusual floods and droughts severely affected large parts of the countryside, resulting in three years with negative rates of agricultural growth. Rice yields remain among the lowest in the region owing to limited and poor use of improved seed, fertilizer, tillage and

9 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 131 Table 6 Major sources of vulnerability along the life cycle. Group Main Sources of Vulnerability Pregnant mothers High maternal mortality rates. Infants and children High malnutrition rates; Poor quality of education/high dropout rates; Child labour and sexual exploitation. Youth Poor quality of education/high dropout rates; Low productivity. Working-age population Low productivity; Disability. Elderly Inability to work. Entire life cycle Health shocks; Natural disasters; Food insecurity; Economic and (food) price crises. water management. Because productive off-farm opportunities are limited, rural households lack alternatives that would enable them to maintain stable incomes or cope in times of poor harvest. T R A D I T I O N A L A N D I N F O R M A L S O C I A L S A F E T Y N E T S The dramatic socio-economic and political changes of the past two decades have had a significant impact on the social fabric of Cambodia. The structure of Cambodian society has changed and its culture has been dislocated. None are more vulnerable to these upheavals than children and women. Families, which provide the first safety net for the survival, protection and healthy development of children, have been fragmented and weakened by death and separation. Communities or villages, once composed of extended family networks established for generations, have been shattered and reformed by forced population movements, displacement and repatriation. Cambodia s traditional social safety net existed in the form of sharing, mutual assistance and, within the pagoda, extended families and neighbour networks through charity and community self-help activities. The monks and the pagoda played an important role in offering meals and temporary shelter to poor and vulnerable people in need within the community. The elderly or very poor are sometimes able to access services at the pagoda, in Muslim communities or in

10 132 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Christian churches, but the availability of such services is limited to a few. Through extended family structures, most vulnerable and poorer members of relatives often received in-kind assistance. Traditional mutual help and support in the form of food and interest-free loans in times of need still exist within kinship systems, extended families and informal networks of occupational groups. Moreover, other forms of safety nets in the modern history of Cambodia can be observed where wealthy families, high-ranking officials, business people and communities extended their own private means to assist and offer help to those who needed the most. Informal arrangements based on kinship and community practices and gifts from wealthy urban groups to poorer rural communities provide households with some protection against risk. Forms of humanitarian support in recent times include emergency assistance from the Cambodian Red Cross and political parties to households affected by disasters and gifts in cash or in kind from political parties. This assistance is needs-based, and poor and vulnerable workers who have met this assessment have received it. However, such assistance, available only as emergency support, is unreliable as a source of security and may come with political strings and/or is insufficient to ensure full recovery from crises. Moreover, such assistance is much rarer today (it was more common before the election of July 2008). B A C K G R O U N D O F S O C I A L P R O T E C T I O N I N C A M B O D I A E X I S T I N G I N S T I T U T I O N A L A N D L E G A L F R A M E W O R K F O R S O C I A L P R O T E C T I O N After the war, Cambodia was moving from a phase of war towards peace, from a culture of continued conflict to a culture of compromise, dialogue and reconciliation. In response to the challenges, the strategy for the National Programme for Rehabilitation and Development of Cambodia (NPRDC) was developed, adopted and implemented. The broad aims of the Government of Cambodia were set out in the NPRDC in February 1994 and elaborated in Implementing NPRDC in February 1995: Striving to Achieve a Sustainable Growth with Equity and Justice. The extensive experience of Cambodia in providing social protection intervention to the people from the most difficult time (1979) to rehabilitation (1991) and national development (post- 1993) is one of the success stories of the country. In the document, war was declared on poverty, and the development of the rural areas is seen as critical to raising the living standards for the majority (80 per cent) of the Cambodian population. Since 1993, rural development has played, and will continue to play, an important and active role in implementing and achieving the goals and targets set forth in the Government s various policy documents, such as the National Programme for Rehabilitation and

11 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 133 Development of Cambodia (NPRDC), the Socio-economic Development Plan (SEDP I-II) and the National Poverty Reduction Strategy (NPRS). Work in the rural-development sector has contributed towards the reduction of poverty in rural areas through decentralized and participatory approaches to the improvement of rural accessibility and to creating opportunities for rurally based people in their own development. The vision of Returning to the Villages was and continues to be the theme for rural-development activities that seek to alleviate poverty through the implementation of projects and programmes that will improve accessibility to socio-economic services in rural areas and that will strengthen and empower the local grassroots organizations at the village level. The goal is to achieve sustainable development and self-reliance. In response to the needs in rural areas, external assistance was provided through loans and grants to rural-development projects and programmes. The Asian Development Bank, the Department for International Development (DFID), the European Union, the German Agency for Technical Cooperation (GTZ), the Japan International Cooperation Agency (JICA), Kreditanstalt für Wiederaufbau, the Swedish International Development Cooperation Agency (SIDA), the World Bank and United Nations entities (i.e., the International Labour Organization (ILO), the United Nations Development Programme (UNDP), the Office of the United Nations High Commissioner for Refugees (UNHCR), the United Nations Children s Fund (UNICEF), the World Food Programme (WFP) and the World Health Organization (WHO)) and other development partners have provided financial and technical assistance to Box 1. Legal framework of social protection stated in the Constitution. Article 36: Article 46: Article 73: Article 74: Article 75: Every Khmer citizen shall have the right to obtain social security and other social benefits as determined by law. The State and society shall provide opportunities to women, especially to those living in rural areas without adequate social support, so they can get employment, medical care, and send their children to school, and to have decent living conditions. The State shall give full consideration to children and mothers. The State shall establish nurseries, and help support women and children who have inadequate support. The State shall assist the disabled and the families of combatants who sacrificed their lives for the nation. The State shall establish a social security system for workers and employees.

12 134 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES improve rural accessibility and increase opportunities for rural people. Rural development activities included but were not limited to the following: rehabilitation of the rural infrastructure such as roads, markets, water supply and sanitation; expansion of rural credit services and income-generating activities; and strengthening of the institutional and human-resource capacity at the national, provincial and local levels. Box 2. Organic laws codifying some aspects of social protection in Cambodia. Organic laws that have codified some aspects of social protection in Cambodia are as follows: Labour Law (October 1998); Insurance Law (June 2000); Law on Social Security Schemes for Persons Defined by the Provisions of the Labour Law (September 2002); National Action Plan to Combat Violence against Women has been developed in accordance with the Law on the Prevention of Domestic Violence and the Protection of Victims (2005); Law on Suppression of Human Trafficking and Sexual Exploitation (2007), consistent with the United Nations Palermo Protocol; and Law on the Protection and the Promotion of the Rights of People with Disabilities (2009). Table 7 Cambodia s Strategic Framework for Social Protection. Dimension(s) of Social Protection Current Sectoral Institution and Social Safety Nets Policy/Strategy National government institutions mandated to deliver social services to the population and to protect specific vulnerable groups against risks Ministry of Labour and Vocational Training National Social Safety Fund for private-sector employees; Vocational training; Child labour elimination programme.

13 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 135 Table 7 Cambodia s Strategic Framework for Social Protection (cont d.). Dimension(s) of Social Protection Current Sectoral Institution and Social Safety Nets Policy/Strategy Ministry of Social Affairs, Veterans and Youth Rehabilitation Ministry of Women s Affairs National government institutions that implement specific safety-net interventions National Social Security Fund for civil servants; Services for veterans; Services for the homeless and destitute, victims of trafficking, children and youths, people living with disabilities; Emergency relief to those affected by natural disasters. Work Platform Ministry of Health Health equity funds; Community-based health insurance for the poor and vulnerable. Health Strategic Plan ; Strategic Framework for Health Financing ; Master Plan for Social Health Insurance Ministry of Education, Youth and Sport Scholarship for the poor programme. Education Sector Strategic Plan National government institutions with complementary activities Ministry of Agriculture, Forestry and Fisheries Ministry of Public Works and Transport Food production, livelihoods. Strategy for Agriculture and Water Implementation of national policy concerning all public works construction. Ministry of Rural Development Rural infrastructure works. Ministry of Water Resources and Meteorology Rural infrastructure works. Ministry of Planning Identification of Poor Households Programme. Ministry of Planning Strategic Plan

14 136 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Safety-net interventions are scattered across several ministries (see tables 7 and 9). Individual ministries and even nongovernmental organizations (NGOs) have their own mandate and policy framework regarding social protection. In developing a National Social Protection Strategy for the Poor and Vulnerable (NSPS), the challenges of separated policy frameworks existing in different stakeholders must be taken into consideration. The Ministry of Labour and Vocational Training, the Ministry of Social Affairs, Veterans and Youth Rehabilitation, and the Ministry of Women s Affairs are all mandated to manage State social services for the wider population and help to protect specific vulnerable groups against risks. In collaboration with the World Food Programme (WFP), the Ministry of Rural Development and the Ministry of Water Resources and Meteorology are also implementing a food-for-work programme that distributes 3,500 tons of rice per year to approximately 20,000 households. The Ministry of Social Affairs, Veterans and Youth Rehabilitation and the Ministry of Labour and Vocational Training are the two main government providers of social protection schemes. The former provides assistance to retired civil servants, veterans and their dependents while the latter oversees social protection schemes for private-sector workers. In 2005, the Government (through the Ministry of Social Affairs, Veterans and Youth Rehabilitation) made payments to civil servants, military, police, disabled people and deceased and/or patriot-dead military and their dependents that totalled US$16.4 million and benefitted 120,000 persons (table 8). It is interesting to note that dependents such as the children and Table 8 Types of pension schemes and beneficiaries. Type of Pensioner Estimated Total Number Amount of Benefits of Beneficiaries (in millions of US$) Retired civil servant* 19, Retired military** 5, Disabled military ( retired)*** 31, Disabled civil servant ( retired)**** 5, Dependent of dead patriot military***** 54, Dependent of dead civil servant 4, Total 119, * Also provides allowance to 13,364 spouses and 13,820 children. ** Also provides allowance to 4,417 spouses and 12,132 children. *** Also provides allowance to 28,607 spouses and 91,328 children. **** Also provides allowance to 102,007 parents and 103,788 children. ***** Also provides allowance to 4,000 children.

15 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 137 Table 9 Social safety nets and social protection framework in various ministries. Risks and Shocks Programme Type Programme Lead Ministry 1. Situations of emergency and crisis Food distribution Budget support Commune transfers for emergency assistance Emergency Food Assistance Project (free distribution of rice) Disaster response and preparedness; general food distribution (Ketsana) Package of emergency relief to vulnerable and victims of emergency (including victims of land mines) Smallholder Agriculture and Social Protection Development Policy Operation Emergency assistance cash and in-kind assistance to communes to support achievement of Cambodian Millennium Development Goals MEF NCDM MoSVY MEF MoI 2. Human development constraints Poor maternal and child health and nutrition Nutrition programmes Social security Child survival: components on improving maternal health and newborn care, promotion of key health and nutrition practices Maternal and Child Health and Nutrition Programme Other interventions Maternity benefits for all workers EXCEPT domestic workers, civil servants, armed forces and police; 90 days of maternity leave; pay at half salary covered by employer (Labour Law Article 183) MoH MoLVT Poor access to quality education Scholarships in cash Fast Track Initiative (FTI) (grades 4-6); Cambodia Education Sector Support Project ( CESSP) (grades 7-9); Japan Fund for Poverty Reduction (JFPR) (grades 7-9); Basic Education and Teacher Training (BETT) Project (grades 7-9); Enhancing Education Quality Project (EEQP) (grades 10-12); Dormitory Project (grades 10-11); various projects (grades 7-9) Emergency Food Assistance Project (grades 5-6 and 8-9) MoEYS MEF Child labour, especially its worst forms Direct intervention and livelihood improvement Project of Support to the National Plan of Action on the Elimination of the Worst Forms of Child Labour (NPA-WFCL) MoLVT Poor access to quality training Second-chance education programme 3. Seasonal Public works unemployment and (PWPs) programmes livelihood opportunities School feeding Take-home rations Technical and Vocational Education and Training (TVET) pilot skills bridging programme TVET post-harvest processing TVET voucher skills training programme (non-formal) Food for work Food for work (Emergency Food Assistance Project) Cash for work (Emergency Food Assistance Project) School feeding Emergency Food Assistance Project Take-home rations MoLVT MRD MEF MEF MoEYS MEF MoEYS

16 138 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Table 9 Social safety nets and social protection framework in various ministries (cont d.). Risks and Shocks Programme Type Programme Lead Ministry 4. Health shocks 5. Special vulnerable groups Insurance Fee waiver Health equity funds (HEFs) Community-based health insurance (CBHI) Social welfare for elderly Pensions Social welfare for families living with disabilities Social welfare and policy development for children and orphans Social welfare for families living with HIV/AIDS For tuberculosis patients National Social Security Fund (NSSF) health insurance (planned for 2011) NSSF employment injury coverage Health insurance for retired civil servants (planned) Exemptions at rural facilities for poor patients HEFs in 50 operational districts (ODs) 13 CBHI schemes Elderly persons' association support and services Invalidity pensions for parents or guardians of deceased soldiers, spouses of people living with disabilities, retirees and people who have lost their ability to work Physical rehabilitation centres/community-based rehabilitation services for people with disabilities Orphans: allowance, alternative care, residential care; child victims of trafficking, sexual exploitation and abuse; children in conflict with the law and drug-addicted children Child protection: helps to develop laws, policies and standards and raise awareness to protect children at particular risk Social services and care to children and families of victims and people affected by HIV/AIDS; children in conflict with the law; drug-addicted children HIV/AIDS workplace programme for garment factory workers Food Assistance to People Living with HIV and AIDS Food Assistance to Tuberculosis Patients 6. Other Pensions Civil servants and veterans retirement pensions NSSF employer-based pension schemes (planned) MoLVT MoSVY MoH MoSVY MoLVT MoH, MoSVY MoSVY MoLVT MEF MoEYS MoH MoI MoLVT MRD MoSVY NCDM NPA-WFCL Ministry of Economics and Finance Ministry of Education, Youth and Sport Ministry of Health Ministry of Interior Ministry of Labour and Vocational Training Ministry of Rural Development Ministry of Social Affairs, Veterans and Youth Rehabilitation National Committee for Disaster Management National Plan of Action on the Elimination of the Worst Forms of Child Labour

17 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 139 the spouse and/or parents of deceased civil servants and deceased military receive pensions. The National Social Security Fund for Civil Servants (NSSF-C), established in 2008, replaces direct payments of social security benefits to civil servants through a contribution-based system that provides a number of benefits: pensions, disability, maternity, work injury, funerals and survivors pensions. It covers 180,000 civil servants and their families. The National Social Security Fund for Private-sector Employees (NSSF), established in 2008, is set to provide, by 2012, the following to all private-sector employees of firms with more than eight employees: (a) employment injury coverage (employment injury insurance was launched in November 2008 and, in December 2009, was already covering 350,000 workers from roughly 900 enterprises), (b) health insurance and (c) pension coverage. NGOs play a significant role in assisting households in distress. In 2007, NGOs channelled roughly 26 per cent of total official development assistance (ODA) in Cambodia (Council for the Development of Cambodia (CDC) ODA database), with US$65 million spent on social protection alone in Within the health sector, much assistance goes towards primary health care and access to hospitals and clinics. In education, it focuses on basic education for the poor and vocational training. NGOs are also very active in providing community and social welfare services through orphanages and general assistance to vulnerable children and youth. G A P S A N D C H A L L E N G E S I N T H E P R O V I S I O N O F S O C I A L P R OT E C T I O N The Government has also identified the following institutional and implementation constraints with regard to the effective and efficient provision of social protection: Safety-net implementation often reflects immediate priorities (such as the need to respond to food and financial crises) rather than a shared longer-term vision for safety-net development. Programmes are often implemented in parallel with the national government structure, failing to build capacity of local government to gradually take over safety-net management, therefore generating a vicious cycle of low local capacity and sustained parallel implementation of programmes. Limited coordination among social protection interventions has resulted in uneven coverage, duplication of efforts, and lack of sustainability and overall impact. Geographic coverage of existing programmes, even the largest ones, is far from universal. Moreover, programmes do not necessarily prioritize poor areas. Targeting has not yet been mainstreamed into safety-net implementation, and many safetynet programmes still rely on ad hoc targeting procedures whose accuracy has not been investigated, adding to transaction costs and inefficiencies.

18 140 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Few programmes or institutions are actually collecting critical monitoring information beyond inputs, outputs and the mere list of beneficiaries, which makes it difficult to assess the effectiveness of ongoing programmes and improve them on an ongoing basis. Even fewer are using monitoring data to improve their procedures on a continuous basis. Moreover, there are few rigorous and thorough evaluations of existing safety-net interventions, making it difficult to assess how well they perform by international standards and where there are areas for improvement. Feedback and complaint resolution systems a central pillar for guaranteeing good governance, transparency and effectiveness of safetynet interventions tend to remain underdeveloped. Very few programmes have evaluated the effectiveness of their feedback systems. As an underlying challenge, the budget for safety-net implementation remains low, with the majority of funding provided by development partners and earmarked for interventions that are often implemented in parallel with the national government system. Table 10 Gaps and challenges in existing interventions. Main Risks and Shocks Most Vulnerable Groups Progress to Date in Response Gaps and Challenges in Response 1. Situations Economic of emergency crises and crisis Climate, environmental, natural disasters All poor and nearpoor. All poor and near-poor; People living in flood- and droughtprone areas. Public works have shown to be an effective and rapidly expandable safety-net instrument during crises and natural disasters. Limited coverage and coordination of existing public works programmes. 2. Human development constraints Poor maternal and child health and nutrition Poor access to quality education Girls and women of reproductive age; Pregnant women; Early childhood (0-5 years). School age (6-14 years). Some maternal and child nutrition programmes are in place; Breastfeeding practices are improving. Scholarships and school feeding programmes are improving attendance. Supply of maternal and child nutrition services remains limited and of poor quality; Coverage of these services is not universal; Other demand-side factors (eating, feeding and care practices) are not being adequately addressed. Quality of education remains poor; Coverage of education services is variable; Coverage of scholarships and school feeding programmes does not reach all poor areas.

19 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 141 Table 10 Gaps and challenges in existing interventions (cont d.). Main Risks and Shocks Most Vulnerable Groups Progress to Date in Response Gaps and Challenges in Response Poor access to quality second-chance programmes Youth (15-24 years). Establishment of vocational training curricula; Some programmes in place for secondchance education. Quality of vocational training remains poor; Supply of second-chance programme is minimal; Poor link between training offered and employers needs; No certification/accreditation system in place for private sector. 3. Seasonal Under- and unemployment and poor nutrition livelihoods opportunities All poor and near-poor; Pregnant women; Early childhood (0-5 years); Families with greater age dependency ratio; Landless and land poor. Some targeted food distribution; School feeding; Public works programmes are providing some assistance during lean season or crises. Limited coverage and coordination of existing public works programmes; Funding and assistance remain volatile. 4. Health shocks Ill-health, injury, illness, death, pandemics All poor and near-poor; Pregnant women; Early childhood (0-5 years); Elderly; People living with a disability. Health equity funds (HEFs) are financing health care for the poor in some areas. Quality of health care remains poor; Coverage/access of HEFs is not universal. 5. Special vulnerable groups Inability to work, marginalization Elderly; People living with a disability; People living with chronic illness; Ethnic minorities; Orphans; Child labourers; Victims of violence, exploitation and abuse; Veterans; Families of migrants. Pensions for civil servants, National Social Security Fund for private-sector employees; Some donor assistance to the disabled; Some assistance to ethnic minorities. No pensions for the poor; Very limited assistance to people with disabilities; Limited assistance to other special vulnerable groups.

20 142 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES P R O G R E S S O N S O C I A L S A F E T Y - N E T D E V E L O P M E N T S C O P I N G A N D M A P P I N G E X E R C I S E O N E X I S T I N G S A F E T Y - N E T P R O G R A M M E S The Government of Cambodia agreed that the first step is to undertake a mapping exercise to determine the nature of the existing provision of safety nets and to identify policy, institutional and capacity gaps for developing a more systematic and integrated safety-net system. To start this process, responsibility for this mapping and scoping exercise is assigned to the Technical Working Group on Food Security and Nutrition (TWG-FSN) (box 3), chaired by the Council for Agricultural and Rural Development. To succeed, this analysis and subsequent safety-net development will require the intensive engagement of social-sector ministries. The starting point for a work programme for the Technical Working Group on Food Security and Nutrition is to prepare the concept note on the assessment of the country s overall situation of social protection. Development partners will support the development of the social safety-net strategy (SSNS) by contributing to the draft and providing technical assistance where possible. The Government, in collaboration with development partners specifically, through the Interim Working Group on Social Safety Nets of the Technical Working Group on Food Security and Nutrition will lead efforts towards a social safety-net strategy. WFP, co-facilitator of the Technical Working Group and the largest SSNS development part- Box 3. The initial role of the Council for Agricultural and Rural Development (CARD) in the mapping and scoping exercise of existing social safety nets. The Technical Working Group on Food Security and Nutrition, working with relevant government institutions and development partners, committed to carrying out the mandate given by the Government as follows:. mapping and scoping by end of May 2009, with World Bank support, building very much on what is already in the draft concept note and pulling together all the available information in a core paper for the July National Forum;. concurrent work on a draft of policy options to be presented at the July Social Safety Net National Forum, which will be supported by the World bank in collaboration with WFP and other development partners of the Interim Working Group on Social Safety Nets;. policy option paper to be finalized by September 2009; CARD/Technical Working Group on Food Security and Nutrition to lead, with the support from development partners; and. Social safety net strategy by December 2009; CARD to lead, development partners to support.

21 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 143 ner, will facilitate coordination with other development partners. On the Government side, the Council for Agricultural and Rural Development will coordinate among the many government agencies with social-policy programmes and an interest in the issue. The overall National Social Protection Strategy is the successful outcome of a long collaboration process between the Government and the development partners and other stakeholder involved, where the initiative comes from the willingness of the Government. T E C H N I C A L C O N S U LTAT I O N O N S O C I A L P R O T E C T I O N S T R AT E G Y A N D O P T I O N S In preparing the National Social Protection Strategy for the Poor and Vulnerable, the Council for Agricultural and Rural Development (CARD) in 2009 and 2010 convened meetings and held technical consultations with a broad set of national stakeholders, giving government representatives (national and subnational), development partners, civil society representatives and other development practitioners the opportunity to explore the options and priorities in depth (table 11). Table 11 Summary of the consultation process on the National Social Protection Strategy for the Poor and Vulnerable. Timeline Activity/event Outcomes 3-4 Dec Jan.-Jun Jul Oct Cambodia Development Cooperation Forum Interim Working Group on Social Safety Nets (under the Technical Working Group on Food Security and Nutrition National Forum on Food Security and Nutrition under the theme of Social Safety Nets in Cambodia Technical Consultation on Cash Transfers, with a focus on addressing child and maternal malnutrition National government commitment to develop and implement an integrated national strategy for social safety nets. Shared knowledge and consensus-building on the key concepts and broad direction for policy development and inventory of ongoing social protection interventions. During the two-day forum, 400 participants (government, development partners and civil society) held discussions, with Prime Minister Hun Sen providing the closing address. Participants from government, development partners and civil society consulted during a workshop in Phnom Penh. A group of participants also visited health and educational services and held discussions with commune councils and the provincial office in Kampong Speu. The consultation culminated in a brainstorming session by key stakeholders to produce the Note on Cash Transfers.

22 144 VOLUME 18: SUCCESSFUL SOCIAL PROTECTION FLOOR EXPERIENCES Table 11 Summary of the consultation process on the National Social Protection Strategy for the Poor and Vulnerable (cont d). Timeline Activity/event Outcomes Jan Technical Consultation on Public Works 80+ participants (government, development partners, civil society) consulted during a workshop in Phnom Penh. The core group (about 30 participants) also visited sites of cash-for-work and food-for-work projects (Asian Development Bank- and WFP-supported interventions) in Kampong Chhnang, including a consultation with representatives of a commune council and beneficiaries of the projects. The consultation culminated in a Next Steps Meeting by CARD and a core group of development partners and the production of the Note on Public Works. 3-4 Feb Technical Consultation on the Role of a National Social Protection Strategy in Augmenting Human Capital through Promoting Education, Reducing Child Labour and Eliminating Its Worst Forms 100+ participants (government, development partners, civil society) consulted during a two-day workshop in Phnom Penh. The consultation built consensus on integrating education and child labour issues into the National Social Protection Strategy (NSPS), particularly in instruments such as cash transfers, as well as the need to explore greater access to safety-net schemes to prevent child labour and withdraw vulnerable children from it, especially its worst forms. The Note on Child Labour and Education was prepared by a core group of development partners as a contribution to the NSPS. Mar.-Apr Consultations on draft National Social Protection Strategy (NSPS) An executive drafting team was set up to prepare and consolidate inputs into the draft NSPS. Several consecutive drafts of the NSPS were shared and discussed in the extended format of the Interim Working Group on Social Safety Nets. Several rounds of consultations on the content of the NSPS and the proposed objectives took place to advance the shaping a coherent strategy. This transparent and rigorous consultation process has ensured that the analytical and policy inputs have gone through several rounds of discussion and are the result of a combined effort by all stakeholders. Coordination and the role of CARD as a focal point of dialogue among stakeholders that have different policies and agendas for achieving the strategy constitute a big success story in Cambodia. T H E D E V E L O P M E N T O F S O C I A L P R O T E C T I O N F O R T H E P O O R A N D V U L N E R A B L E Another success story in Cambodia is the achievement of developing a strategy for national social protection for the poor and vulnerable. The development of this strat-

23 Cambodia The National Social Protection Strategy for the Poor and Vulnerable: Process of Development 145 egy is mainly based on the triangulation of three specific environments (fig. 1). The legal direction is the result of Cambodia s high-level legal framework, where social protection is a priority of the national government, as expressed in the Constitution, in the Rectangular Strategy for Growth, Employment, Equity and Efficiency - Phase II, in the National Strategic Development Plan Update and in various national laws (see box 2). Also important are international conventions to which Cambodia is a signatory. Identification of the gaps in the existing social protection programmes, meanwhile, provided a strong learning experience on which to draw in developing the strategy. Numerous social protection programmes and interventions have been implemented successfully across a range of sectors. Figure 1 Triangulation of environments to develop the National Social Protection Strategy for the Poor and Vulnerable. The main rationale behind a National Social Protection Strategy for the Poor and Vulnerable (NSPS) is the need to accelerate progress towards meeting the Cambodian Millennium Development Goals. Achievement of these Goals has been further delayed by the recent food, fuel and financial crises, which have had a negative impact on the poor and widened social disparities. Social protection, a crosscutting policy area, can address the challenges involved in reducing poverty, inequality and disparities. The strategic intent of the NSPS is to achieve socio-economic security for the population as outlined in the Rectangular Strategy - Phase II, the National Strategic Development Plan Update , and sectoral policies and plans and to bring coherence across policy formulation and implementation. Another consideration is the fact that chronic poverty resulted from three decades of civil wars and the recent eco-